Клеточные и молекулярные механизмы воспаления слизистой оболочки пищевода при различном клиническом течении гастроэзофагеальной рефлюксной болезни и ее осложнений
Клеточные и молекулярные механизмы воспаления слизистой оболочки пищевода при различном клиническом течении гастроэзофагеальной рефлюксной болезни и ее осложнений
Клеточные и молекулярные механизмы воспаления слизистой оболочки пищевода при различном клиническом течении гастроэзофагеальной рефлюксной болезни и ее осложнений
В обзоре представлены современные данные о клеточных и молекулярных механизмах воспалительных изменений слизистой оболочки пищевода при воздействии на нее различных типов рефлюктатов (желудочный, желчный или дуоденогастральный/смешанный). Авторами приведены данные о ключевых медиаторах воспаления при гастроэзофагеальной рефлюксной болезни (ГЭРБ) и их основных клеточных источниках, изменении иммунного профиля пациентов. Рассматриваются вопросы возможного влияния изменений клеточных и молекулярных компонентов формирования воспалительной реакции в пищеводе на особенности клинического течения ГЭРБ и развитие ее рефрактерных к терапии форм.
The review presents modern data on the cellular and molecular mechanisms of inflammatory changes of esophageal mucosa exposed to different types of reluctate (gastric, biliary or duodenal/mixed). The authors describe data on key mediators of inflammation in gastroesophageal reflux disease (GERD) and their major cellular sources, changes of the immune profile of patients. Discusses the possible impact of changes in the cellular and molecular components in the development of the inflammatory response in the esophagus on the clinical features of GERD and its therapy-refractory forms.
Keywords: gastroesophageal reflux disease, Barrett's esophagus, pH-metry, inflammation, reflux, fibrogenesis, cytokines, macrophages, the phenotype of macrophages.
Список литературы
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________________________________________________
1. Souza RF. Reflux esophagitis and its role in the pathogenesis of Barrett’s metaplasia. J Gastroenterol. 2017;52:767-76. doi: 10.1007/s00535-017-1342-1
2. Spechler SJ, Souza RF. Barrett’s esophagus. N Engl J Med. 2014; 371:836-45.
3. Plotnikova EYu, Vologzhanina LG, Samsonov AA, Andreev DN, Samsonova OA. The course of gastroesophageal reflux disease according to the retrospective 5-year follow-up. Farmateka. 2016;(6):64-8 (In Russ.)
4. El-Serag HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. Obesity increases oesophageal acid exposure. Gut. 2007;56(6):749-55. doi: 10.1136/gut.2006.100263
5. Evsyutina YuV. Clinical and morphological characteristics of gastroesophageal reflux disease refractory to treatment with proton pump inhibitors [dissertation]. Moscow: I.M. Sechenov First Moscow State Medical University; 2015 (In Russ.). Available at: http://www.gastroscan.ru/ disser/evsytina-yv-diss.pdf
6. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900-20; quiz 1943.
7. Ambarus CA, Krausz S, van Eijk M, Hamann J, Radstake TR, Reedquist KA, Tak PP, Baeten DL. Systematic validation of specific phenotypic markers for in vitro polarized human macrophages. J Immunol Meth. 2012;375(1-2):196-206. doi: 10.1016/j.jim.2011.10.013
8. Fritz J, Murphy BS, Sundareshan V, Cory TJ, Hayes DI, Anstead MI, Feola DJ. M1 and M2 Macrophage activation. Azithromycin alters macrophage phenotype. J Antimicrob Chemother. 2008;61(3):554-60.
9. Maev IV, Vuychnova ES, Schekina MI. Gastroesophageal reflux disease – Disease of XXI century. Attending Doctor. 2004;4:10-14.
10. Trukhmanov AS. Barrett’s esophagus: epidemiology, pathogenesis, clinical course and prevention. Rossiiskii Zhurnal Gastroenterologii, Gepatologii, Koloproktologii. 2002;12(5):59-62 (In Russ.)
11. Ivashkin VT, Maev IV, Trukhmanov AS, Baranskaya EK, Dronova OB, Zairat'yants OV, Pasechnikov VD, Saifutdinov RG, Sheptulin AA, Kucheryavyi YuA, Lapina TL, Storonova OA, Kaibysheva VO. Gastroezofageal’naya refluksnaya bolezn’. Klinicheskie rekomendatsii [Gastroesophageal reflux disease. Clinical guidelines]. Moscow: The Russian gastroenterological Association; 2014. 23 p. (In Russ.)
12. Katz P, Gerson L, Vela M. Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2013;108:308-28. doi: 10.1038/ajg.2012.444
13. Tack J. Review article: the role of bile and pepsin in the pathophysiology and treatment of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2006;24 Suppl 2:10-6.
14. Vaezi MF, Singh S, Richter JE. Role of acid and duodenogastric reflux in esophageal mucosal injury: a review of animal and human studies. Gastroenterology. 1995;108(6):1897-907.
15. Karamanolis G, Vanuytsel T, Sifrim D, Bisschops R, Arts J, Caenepeel P, Dewulf D, Tack J. Yield of 24-h esophageal pH and bilitec monitoring in patients with persisting symptoms on PPI therapy. Dig Dis Sci. 2008;53:2387-93. doi: 10.1007/s10620-007-0186-6
16. Tack J, Koek G, Demedts I, Sifrim D, Janssens J. Gastroesophageal reflux disease poorly responsive to single-dose proton pump inhibitors in patients without Barrett's esophagus: acid reflux, bile reflux, or both? Am J Gastroenterol. 2004;99:981-8.
17. Siddiqui A, Rodriguez-Stanley S, Zubaidi S, Miner PB Jr. Esophageal visceral sensitivity to bile salts in patients with functional heartburn and in healthy control subjects. Dig Dis Sci. 2005;50:81-5.
18. Kauer WK, Peters JH, DeMeester TR, Ireland AP, Bremner CG, Hagen JA. Mixed reflux of gastric and duodenal juices is more harmful to the esophagus than gastric juice alone. The need for surgical therapy re-emphasized. Ann Surg. 1995;222(4):525-31.
19. Vela MF, Camacho-Lobato L, Srinivasan R, Tutuian R, Katz PO, Castell DO. Simultaneous intraesophageal impedance and pH measurement of acid and nonacid gastroesophageal reflux: effect of omeprazole. Gastroenterology. 2001;120:1599-606.
20. Sifrim D, Holloway R, Silny J, Xin Z, Tack J, Lerut A, Janssens J. Acid, nonacid, and gas reflux in patients with gastroesophageal reflux disease during ambulatory 24-h pH-impedance recordings. Gastroenterology. 2001;120:1588-98.
21. Bredenoord AL, Smout AJ. Refractory gastrooesophageal reflux disease. Eur J Gastroenterol Hepatol. 2008;20:217-23.
22. Mainie I, Tutuian R, Shay S, Vela M, Zhang X, Sifrim D, Castell DO. Acid and non-acid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring. Gut. 2006;55(10):1398-402.
23. Zerbib F, Roman S, Ropert A, des Varannes SB, Pouderoux P, Chaput U, Mion F, Vérin E, Galmiche JP, Sifrim D. Esophageal pH-impedance monitoring and symptom analysis in GERD: a study in patients off and on therapy. Am J Gastroenterol. 2006;101(9):1956-63.
24. Katz P, Gideon RM, Tutuian R. Reflux symptoms on twice daily (BID) proton pump inhibitor (PPI) associated with non acid reflux; a manifestation of hypersensitive esophagus? Am J Gastroenterol. 2005;128: A-130, 31-3.
25. Kaibysheva VO, Storonova OA, Trukhmanov AS, Ivashkin VT. Potentials of intraesophageal pH-impedance measurement in GERD diagnostics. Rossiiskii Zhurnal Gastroenterologii, Gepatologii, Koloproktologii. 2013;23(2):4-16 (In Russ.)
26. Rossetti G, Limongelli P, Cimmino M, Napoletano D, Bondanese MC, Romano G, Pratilas M, Guerriero L, Orlando F, Conzo G, Amato B, Docimo G, Tolone S, Brusciano L, Docimo L, Fei L. Outcome of medical and surgical therapy of GERD: predictive role of quality of life scores and instrumental evaluation. Int J Surg. 2014;12 Suppl 1:S112-6. doi: 10.1016/j.ijsu.2014.05.034
27. Evsyutina YuV, Trukhmanov AS. A new look at the problem of gastroesophageal reflux disease refractory to treatment with proton pump inhibitors. Rossiiskii Zhurnal Gastroenterologii, Gepatologii, Koloproktologii. 2014;24(5):4-9 (In Russ.)
28. Lyamina SV, Maev IV, Yurenev GL, Malyshev IYu. Asthma and gastroesophageal reflux disease: a view of the clinician and pathophysiology. Terapevticheskii Arkhiv. 2011;(6):73-8 (In Russ.)
29. Rieder F, Biancani P, Harnett K, Yerian L, Falk GW. Inflammatory mediators in gastroesophageal reflux disease: impact on esophageal motility, fibrosis, and carcinogenesis. Am J Physiol Gastrointest Liver Physiol. 2010;298:571-81.
30. Fiocchi C. Intestinal inflammation: a complex interplay of immune and nonimmune cell interactions. Am J Physiol Gastrointest Liver Physiol. 1997;273:769-75.
31. O’Shaughnessy JA, Kelloff GJ, Gordon GB, Dannenberg AJ, Hong WK, Fabian CJ, Sigman CC, Bertagnolli MM, Stratton SP, Lam S,
Nelson WG, Meyskens FL, Alberts DS, Follen M, Rustgi AK, Papadimitrakopoulou V, Scardino PT, Gazdar AF, Wattenberg LW, Sporn MB, Sakr WA, Lippman SM, von Hoff DD. Treatment and prevention of intraepithelial neoplasia: an important target for accelerated new agent development. Clin Cancer Res. 2002;8:314-46.
32. Fornari F, Blondeau K, Mertens V, Tack J, Sifrim D. Nocturnal gastroesophageal reflux revisited by impedance-pH monitoring. J Neurogastroenterol Motility. 2011;17(2):148-57. doi: 10.5056/jnm.2011
33. Karamanolis GP, Sifrim D. Patients with refractory gastroesophageal reflux disease: diagnostic tools. Ann Gastroenterol: Quarterly publication of the Hellenic Society of Gastroenterology. 2013;26(1):6-10.
34. Isomoto H, Inoue K, Kohno S. Interleukin-8 levels in esophageal mucosa and long-term clinical outcome of patients with reflux esophagitis. Scand J Gastroenterol. 2007;42(3):410-1.
35. Cheng L, Cao W, Behar J, Fiocchi C, Biancani P, Harnett KM. Acid-induced release of platelet-activating factor by human esophageal mucosa induces inflammatory mediators in circular smooth muscle.
J Pharmacol Exper Ther. 2006;319(1):117-26.
36. Kohata Y, Fujiwara Y, Machida H, Okazaki H, Yamagami H, Tanigawa T, Watanabe K, Watanabe T, Tominaga K, Wei M, Wanibuchi H, Arakawa T. Role of Th-2 cytokines in the development of Barrett's esophagus in rats. J Gastroenterol. 2011;46(7):883-93. doi: 10.1007/ s00535-011-0405-y
37. Zhong YQ, Lin Y, Xu Z. Expression of IFN-γ and IL-4 in the esophageal mucosa of patients with reflux esophagitis and Barrett's esophagus and their relationship with endoscopic and histologic grading. Dig Dis Sci. 2011;56(10):2865-70. doi: 10.1007/s10620-011-1696-9
38. Isomoto H, Saenko VA, Kanazawa Y, Nishi Y, Ohtsuru A, Inoue K, Akazawa Y, Takeshima F, Omagari K, Miyazaki M, Mizuta Y, Murata I, Yamashita S, Kohno S. Enhanced expression of interleukin-8 and activation of nuclear factor kappa-B in endoscopy-negative gastroesophageal reflux disease. Am J Gastroenterol. 2004;99(4):589-97.
39. O'Riordan JM, Abdel-Latif MM, Ravi N, McNamara D, Byrne PJ, McDonald GS, Keeling PW, Kelleher D, Reynolds JV. Proinflammatory cytokine and nuclear factor kappa-B expression along the inflammation-metaplasia-dysplasia-adenocarcinoma sequence in the esophagus. Am J Gastroenterol. 2005;100(6):1257-64.
40. Williams IR, Kupper TS. Immunity at the surface: homeostatic mechanisms of the skin immune system. Life Sci. 1996;58(18):1485-507.
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